Aquifer Family Medicine
First-degree Relative correct answersFHx Risk Factor for BCx
- No Breast Self Exams
- Insufficienct evidence for clinical breast exams
- Mammography > 40 correct answersUSPSTF Breast Recommendations (3)
40 correct answersWhen USPSTF recommends starting mammograms
- CBE every 3 yrs until 40
- Annually after 40 correct answersACS Breast recommendations
- Cervical cancer starts screen at 21
- 21-29 q3y
- 30-65 q5y if HPV co-tested or q3y cytology alone correct answersUSPSTF Cervical cancer recs
21 and 65 correct answersWhen to start and stop cervical cancer screening?
Transmitted by oral or vaginal intercourse
- age
- nutritional status
- immune function
- SNPS correct answersWhat factors modulate the incorporation of HPV?
- Early intercourse
- More lifetime partners correct answersTwo sexual behaviors associated with increased risk cervical cancer
- DES exposure in utero
- Cigarette smoking (4X)
- Immunosuppression correct answers3 non-sexual risk factors associated with increased cervical cancer
Sensativity correct answersMeasure proportion of actual positives
Specificity correct answersMeasure the proportion of actual negatives
- accuracy (high sensativity and specificity)
- Minimal associated risk
- able to detect disease in asymptomatic people
- Reasonable cost
- Acceptable to patient - Have an available treatment correct answers6 characteristic of a good screening test
Test is - inexpensive
- easy to perform
- acceptable to patients
- has a long pre-invasive state
- sensitivity 30-80% and specificity 86-100% correct answersPap test characteristics (5)
- Insufficient evidence for screening correct answersUSPSTF Skin Cancer recommendations
- low-dose CT for patients 55-80 who have 30+ pack years
- Consider in current smokers and those who have quit in last 15 yrs correct answersUSPSTF Lung Cancer recommendations
55-80 correct answersWhen does USPSTF recommend a low dose CT in those with 30+ pack years?
- recommends against screening in asymptomatic women correct answersUSPSTF Ovarian cancer recommendations
- biennial screening for women 50-74 correct answersUSPSTF BCx recommendations
- 40-44 annual (optional)
- 45-54 annual
>55 biennial correct answersACS BCx recommendations
- location
- noticed
- presentation
- discharge
- size correct answers5 factors to note when examining a breast lump
Single, hard, immobile nodule >2 cm with irregular borders correct answersHigh risk breast lesion
- Mammography
- US
- Biopsy - Can do FNA if feels cystic but not recommended correct answersEvaluation of a breast lump (3 steps)
- pregnancy
- physiology correct answersTwo physiologic causes of nipple discharge - Prolactinoma
- BCx: intraductal papilloma, mammary duct ectasia, paget disease of breast
- DCIS
- Hormone imbalance
- Trauma
- Abscess
- Iatrogenic: Antidepressants, antipsychotics, antihypertensives correct answersPathologic causes of nipple discharge
- FHx in 1st degree
- Menarche before 12
- Menopause after 45
- BRCA 1 or 2
- Adanvaced age
- Female sex
- Increased breast density correct answers7 non-modifiable risk factors for BCx
- Advanced age at first pregnancy
- DES exposure
- Hormone therapy correct answers3 modifiable risk factors for BCx
- Therapeutic radiation
- Obesity
- Smoking
- Alcohol correct answers4 Environmental risk factors for BCx
- Early pregnancy
- Late menarche
- High parity
- Early menopause
- Meds: NSAIDS, aspiring, SERMs correct answers5 factors associated with decreased
BCx
Gail Criteria correct answersCan be used to calculate risk and advice on mammograms
TDap correct answersVaccination against tetanus used in adults 19-64
12 months without menstruation correct answersConfirmed menopause
51 correct answersAverage age at menopause
- younger in smokers
Perimenopause
- can still get pregnant - lasts 2-8 yrs correct answersGradual transition to menopause - Hot flashes
- Vaginal dryness
- Mood swings correct answers3 Symptoms of menopause
- light layers
- regular exercise
- avoid spicy foods
- managing stress correct answers4 recommendations for hot flashes - neck and face flush
- last 30s to 10 min
- Water soluble lubricant correct answersRecommendation for vaginal dryness with menopause
- Insufffienct evidence to assess calcium and vit D supplementation
- Recommending against in pre- and post-menopausal women correct answersUSPSTF osteoporosis prevention recommendations
- increase dairy intake
- include weight bearing exercise correct answersTwo recommendations to prevent osteoporosis
> 65 DEXA
< 65 if risk of facture is >65 white woman (9.3% over 10 yr) correct answersUSPSTF recommendation for osteoporosis screening
- low estrogen state - menopause - prolonged amenorrhea - low weight/BMI
- low physical activity
- low CA intake
- FHx
- Hx fracture as an adult
- Cigarette smoking
- White race correct answersRisk factors for osteoporosis (7)
- HTN
- CAD
- Stroke
- OA
- DM 2 correct answers5 disease that increase wiht increased BMI - exacerbated by smoking, sedentary lifestyle, old age
Choose my plate correct answersWebstie for healthy eating
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